Homosexual Status as a Contributing Factor to Depression and Anxiety in Young Men

Research found increased incidence of mental health issues in young gay and bisexual men.

Gay and bisexual men younger than 26 years are 2 times more likely to experience depression and anxiety, and are up to 7 times more likely to inflict self-harm or attempt suicide than those older than age 45, according to a new community-based study reported in the Journal of Public Health by researchers from the United Kingdom.

“Earlier research shows higher rates of mental ill health among sexual minorities than the sexual majority,” said lead author Ford Hickson, BSc, BA, PhD, AFHEA, Course Director Public Health MSc at the London School of Hygiene and Tropical Medicine, but a lack of data exists on patterns of mental illness among non-heterosexuals.

Although lesbian-gay-bisexual-transgender (LGBT) individuals make up a very small percentage of the general population, there are several other factors contributing to a lack of data on mental health within the LGBT community. The group itself is falsely perceived to be homogenous, producing a sample bias that reduces emphasis on inclusion in studies.1 This, combined with the absence of a sampling frame in research for minorities based on sexual preference, has limited the research conducted in this subpopulation.2-4

The purpose of the current study was to describe inequality in mental health indicators among gay and bisexual men. To that end, the investigators specifically recruited a cohort of 5799 gay and bisexual men aged 16 and older from the England, Wales, and Scotland to complete the Stonewall Gay & Bisexual Men's Health Survey, an anonymous, self-completed, online questionnaire.

The majority (78%) of participants were younger than 45 (median age, 32); 94% were white; and 58% had degree-level education. Financial status was broadly distributed across all income levels, and equal numbers reported living alone, with a male partner, or with a nonpartner.

The assessments indicated that mental health issues—including depression (21.3%) and anxiety (17.1%)—were common in this group. In the previous 12 months, 3% reported attempting suicide and 6.5% had inflicted self-harm. Dr Hickson pointed to Meyer's minority stress theory5 implicating sexual status as a factor in mental health issues; specifically, that regular experience of homophobia and social oppression directly contribute to a higher incidence of anxiety and mood disorders among white LGBT individuals.5,6

The most prominent trend to emerge was the decrease in incidence of all indicators of poorer mental health with increasing age, higher educational level, and higher financial status. Cohabitation with a male partner and living in London were both shown to be protective against mental illness.

Practical Applications

The outcomes of the survey suggest that mental health interventions in gay and bisexual men need to primarily target younger men. “The population level patterns of mental ill health suggest that interventions at levels other than the individual level are required,” Dr Hickson said. “Central and local government policies that promote meaningful participation (eg, maximizing employment, promoting community cohesion) and foster a sense of belonging (eg, inclusive education health and social services, opportunities for voluntary organizing) are central to the mental health of the country.” He pointed out that consideration of the roles of sex, gender, and sexuality in these policies will expand their social impact.